This study aims to compare the functional outcome of Isolated Flexor hallucis longus tendon transfer and Gastrocnemius Augmented Flexor hallucis longus tendon transfer in repair of Achilles tendon defects. Also, compare the two procedures regarding complication rate, time to restore the function, and the need for secondary procedures.
Age range: Adolescents and adults with skeletally mature feet (above 12 y in females and 14 years in males).
Achilles Tendon defects more than 4 cm resulted from acute or chronic rupture, post-debridement defects in case of neglected insertional tendinopathy, spontaneous ruptures due to tendinosis or after tumor resection.
General medical contraindications to surgical interventions
Calcaneal Fracture, subtalar fusion
infection or previous surgery in the ipsilateral hindfoot or ankle
Systemic disease including seronegative inflammatory diseases, spondyloarthropathies or sarcoidosis.